Reducing the need for hospitalisation in patients with chronic obstructive pulmonary disease (COPD) is an important goal in COPD management. The aim of this study was to evaluate re-hospitalisation, treatment, comorbidities and mortality in patients with COPD who were hospitalised for the first time due to a COPD exacerbation.
This was a retrospective, population-based observational cohort study of Swedish patients using linked data from three mandatory national health registries to assess re-hospitalisation rates, medication use and mortality. Rate of hospitalisation was calculated using the number of events divided by the number of person-years at risk; risk of all-cause and COPD-related mortality were assessed using Cox proportional hazard models.
In total, 51,247 patients were identified over 10 years; 35% of patients were not using inhaled corticosteroid, long-acting muscarinic antagonist or long-acting β-agonist treatment prior to hospitalisation, 38% of whom continued without treatment after becurrent comorbidities had an increased risk of being re-hospitalised.Improving patients' information needs (IN) may contribute to better control in COPD. This study analyses IN using Lung Information Needs Questionnaire (LINQ) following an educational intervention, evaluates how clinical characteristics modify IN, and studies high IN as a prognostic factor for COPD exacerbations and hospital admissions.
Cohort of 143 patients with initial diagnosis of COPD included in a structured educational program. Two months after completing the program, IN was assessed using LINQ. Correlations between IN and clinical variables of COPD and distribution of IN in different clinical groups were analyzed. Univariate and multivariate analysis was performed to determine influence of IN on exacerbations and COPD admissions over the following year.
LINQ scored 6.3±2.9. There were no differences in LINQ scoring between different clinical groups, but LINQ score positively correlated with age (r=0.184, p=0.029). High IN was a predictor of COPD hospitalizations (HR 2.3 [95% CI 1.1-5.1] (p=0.029)) but not of less severe exacerbations (p=0.334).
IN was not associated with any clinical variables, but it correlated with age. High IN proved to be an independent predictor of admissions.
IN was not associated with any clinical variables, but it correlated with age. High IN proved to be an independent predictor of admissions.The purpose of this study was to assess the feasibility and examine the preliminary effectiveness of a mobile application-based meal assistant training program (APP) for use by direct care workers (CAs) assisting residents with dementia in long-term care facilities in South Korea.
We adopted a mixed methods research design, which included a pre- and post-intervention study and focus group interviews for the feasibility assessment. Participants included 23 dyads of older adults with dementia and their CAs from a long-term care facility in South Korea. Upon completion of the APP intervention, focused group interviews were conducted with six CAs and five nurses.
The results of paired -tests showed that the effects of the APP intervention on the older adults with dementia and their CAs were not significant; however, the results of the focused group interviews support the potential usefulness of the APP for CAs.
The APP may be applicable to long-term care workers who need meal assistant skills education.
The APP may be applicable to long-term care workers who need meal assistant skills education.To explore the effects of different lifestyle choices on mild cognitive impairment (MCI) and to establish a decision tree model to analyse their predictive significance on the incidence of MCI.
Study participants were recruited from geriatric and physical examination centres from October 2015 to October 2019 330 MCI patients and 295 normal cognitive (NC) patients. Cognitive function was evaluated by the Mini-Mental State Examination Scale (MMSE) and Clinical Dementia Scale (CDR), while the Barthel Index (BI) was used to evaluate life ability. https://www.selleckchem.com/ Statistical analysis included the test, logistic regression, and decision tree. The ROC curve was drawn to evaluate the predictive ability of the decision tree model.
Logistic regression analysis showed that low education, living alone, smoking, and a high-fat diet were risk factors for MCI, while young age, tea drinking, afternoon naps, social engagement, and hobbies were protective factors for MCI. Social engagement, a high-fat diet, hobbies, living condition, tea drinking, and smoking entered all nodes of the decision tree model, with social engagement as the root node variable. The importance of predictive variables in the decision tree model showed social engagement, a high-fat diet, tea drinking, hobbies, living condition, and smoking as 33.57%, 27.74%, 22.14%, 11.94%, 4.61%, and 0%, respectively. The area under the ROC curve predicted by the decision tree model was 0.827 (95% CI 0.795~0.856).
The decision tree model has good predictive ability. MCI was closely related to lifestyle; social engagement was the most important factor in predicting the occurrence of MCI.
The decision tree model has good predictive ability. MCI was closely related to lifestyle; social engagement was the most important factor in predicting the occurrence of MCI.Isometric strength measures and timed up and go (TUG) tests are both recognized as valuable tools for fall prediction in older adults. However, results from direct comparison of these two tests are lacking. We aimed to assess the potential of isometric strength measures and the different modalities of the TUG test to detect individuals at risk of falling.
This is a prospective cohort study including 24 community-dwelling older adults (?65 years, 19 females, 88±7 years). Participants performed three variations of the TUG test (standard, counting and holding a full cup) and three isometric strength tests (handgrip, knee extension and hip flexion) at several time points (at baseline and every ~6 weeks) during a one-year follow-up. The association between these tests and the incidence of falls during the follow-up was assessed.
Twelve participants out of 24 participants experienced falls during the follow-up. Fallers showed a significantly lower handgrip strength (-5.7 kg, 95% confidence interval -10.4 to -1.